the payers jumping on this stuff."
For physicians who use either of
the new endoscopic procedures
covered by the new code, the
national unadjusted payment value
is $445.34. For outpatient facilities,
the national unadjusted payment
value, under the corresponding
code C-APC5331 ("complex GI
procedures") is $3,613.57.
But as the American
Gastroenterological Association
notes, by classifying the new code
under "complex GI procedures"
and assigning a status indicator of
"J1," CMS signaled disagreement
with some advocates and deter-
mined that payments for the pro-
cedure should be bundled.
"Unfortunately, that means on the
facility side you can only bill one
code," says Ms. Woodcock. "You
can't bill supplies or anything
extra."
History is replete with examples
of new approaches that have been
hindered by slow-to-accept payers.
The Stretta system, an endoscopic
approach to GERD that was
cleared by the FDA in 2000, is still
F E B R U A R Y 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 1 3 5
